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Saturday, October 22, 2022

Hazing

From Wikipedia, the free encyclopedia
 
Hazing of French military pilot at 1,000 hours flight time

Hazing (American English), initiation, beasting (British English), bastardisation (Australian English), ragging (South Asian English) or deposition refers to any activity expected of someone in joining or participating in a group that humiliates, degrades, abuses, or endangers them regardless of a person's willingness to participate.

Hazing is seen in many different types of social groups, including gangs, sports teams, schools, cliques, universities, military units, prisons and fraternities and sororities. The initiation rites can range from relatively benign pranks to protracted patterns of behavior that rise to the level of abuse or criminal misconduct. Hazing is often prohibited by law or institutions such as colleges and universities because it may include either physical or psychological abuse, such as humiliation, nudity, or sexual abuse.

Terms

In some languages, terms with a religious theme or etymology are preferred, such as baptism or purgatory (e.g. baptême in Belgian French, doop in Belgian Dutch, chrzciny in Polish) or variations on a theme of naïveté and the rite of passage such as a derivation from a term for freshman, for example bizutage in European French, ontgroening ("de-green[horn]ing") in Dutch and Afrikaans (South Africa and Namibia), novatada in Spanish, from novato, meaning newcomer or rookie or a combination of both, such as in the Finnish mopokaste (literally "moped baptism"). In Latvian, the word iesvētības, which literally means "in-blessings", is used, also standing for religious rites of passage, especially confirmation. In Swedish, the term used is nollning, literally "zeroing". In Portugal, the term praxe, which literally means "practice" or "habit", is used for initiation. In Brazil, it is called trote and is usually practiced at universities by older students (doutores and veteranos) against newcomers (calouros) in the first week of their first semester. In the Italian military, instead, the term used was nonnismo, from nonno (literally "grandfather"), a jargon term used for the soldiers who had already served for most of their draft period. A similar equivalent term exists in the Russian military, where a hazing phenomenon known as dedovshchina (дедовщи́на) exists, meaning roughly "grandfather" or the slang term "gramps" (referring to the senior corps of soldiers in their final year of conscription). At education establishments in India, Pakistan, Bangladesh and Sri Lanka, this practice involves existing students baiting new students and is called ragging. In Polish schools, hazing is known as kocenie (literally catting, coming from the noun kot cat)[citation needed]. It often features cat-related activities, like competitive milk drinking. Other popular tasks include measuring a long distance (i.e. hallways) with matches. Less loaded names for hazing are otrzęsiny (related to the verb otrząsać get over, rally but also shake off/out—as being a novice is a negative state that should be quit) and chrzciny mentioned above.

Hazings are sometimes concentrated in a single session, which may be called a hell night, prolonged to a hell week, or over a long period, resembling fagging. When done on a persons birthday, it can be called birthday spanking.

Methods

One way of initiating a new member into a street gang is for multiple other members of the gang to assault the new member with a beating.

Hazing activities can involve forms of ridicule and humiliation within the group or in public, while other hazing incidents are akin to pranks. A snipe hunt is such a prank, when a newcomer or credulous person is given an impossible task. Examples of snipe hunts include being sent to find a tin of Tartan paint, or a "dough repair kit" in a bakery, while in the early 1900s rookies in the Canadian military were ordered to obtain a "brass magnet" when brass is not magnetic.

Spanking is done mainly in the form of paddling among fraternities, sororities and similar clubs, sometimes over a lap, a knee, furniture or a pillow, but mostly with the victim "assuming the position", i.e., simply bending over forward. A variation of this (also as punishment) is trading licks. This practice is also used in the military. Alternative modes (including bare-buttock paddling, strapping and switching, as well as mock forms of antiquated forms of physical punishments such as stocks, walking the plank and running the gauntlet) have been reported.

Paddling depicted on 1922 cover of College Humor magazine.

The hazee may be humiliated by being hosed or by sprinkler or buckets; covered with dirt or with (sometimes rotten) food, even urinated upon. Olive or baby oil may be used to "show off" the bare skin, for wrestling or just slipperiness, e.g., to complicate pole climbing. Cleaning may be limited to a dive into water, hosing down or even paddling the worst off. They may have to do tedious cleaning including swabbing the decks or cleaning the toilets with a toothbrush. In fraternities, pledges often must clean up a mess intentionally made by brothers which can include fecal matter, urine, and dead animals.

Servitude such as waiting on others (as at fraternity parties) or various other forms of housework may be involved, often with tests of obedience. In some cases, the hazee may be made to eat raw eggs, peppers, hot sauce, or drink too much alcohol. Some hazing even includes eating or drinking vile things such as bugs or rotting food.

Native American okipa ceremony as witnessed by George Catlin, circa 1835

The hazee may have to wear an imposed piece of clothing, outfit, item or something else worn by the victim in a way that would bring negative attention to the wearer. Examples include a uniform (e.g. toga); a leash or collar (also associated with bondage); infantile and other humiliating dress and attire.

Markings may also be made on clothing or bare skin. They are painted, written, tattooed or shaved on, sometimes collectively forming a message (one letter, syllable or word on each pledge) or may receive tarring and feathering (or rather a mock version using some glue) or branding.

Submission to senior members of the group is common. Abject "etiquette" required of pledges or subordinates may include prostration, kneeling, literal groveling, and kissing body parts.

Other physical feats may be required, such as calisthenics and other physical tests, such as mud wrestling, forming a human pyramid, or climbing a greased pole. Exposure to the elements may be required, such as swimming or diving in cold water or snow.

Orientation tests may be held, such as abandoning pledges without transport. Dares include jumping from some height, stealing from police or rival teams and obedience. Blood pinning among military aviators (and many other elite groups) to celebrate becoming new pilots is done by piercing their chests with the sharp pins of aviator wings.

On a pilot's first solo flight, they are often drenched with water, as well as having the back of their shirt cut off to celebrate the achievement. Cutting off the back of the shirt originates from the days of tandem trainers, where the instructor sat behind the student and tugged on the back of their shirt in order to get their attention. Cutting off the back of the shirt symbolizes that the instructor has no need to do that anymore.

On their first crossing the equator in military and commercial navigation, each "pollywog" is subjected to a series of tests usually including running or crawling a gauntlet of abuse and various scenes supposedly situated at King Neptune's court. A pledge auction is a variation on the slave auction, where people bid on the paraded pledges.

Hazing also occurs for apprentices in some trades. In printing, it consists of applying bronze blue to the apprentice's penis and testicles, a color made by mixing black printers ink and dark blue printers ink, which takes a long time to wash off. Similarly, mechanics get their groins smeared with old dirty grease.

Hazing by women of their suitors, often assisted by the women's friends, can also play a role in budding romantic relationships, usually taking mental and psychological rather than physical forms, and apparently for the same basic purposes as other hazing.

Psychology, sociology, purpose and effects

Hazing supposedly serves a deliberate purpose of building solidarity. Psychologist Robert Cialdini uses the framework of consistency and commitment to explain the phenomenon of hazing and the vigor and zeal to which practitioners of hazing persist in and defend these activities even when they are made illegal. Cialdini cites a 1959 study in which the researchers observed that "persons who go through a great deal of trouble or pain to attain something tend to value it more highly than persons who attain the same thing with a minimum of effort". The 1959 study shaped the development of cognitive dissonance theory by Leon Festinger.

There are several psychological effects that both the hazer and hazee endure throughout the hazing process. In an article published by Raalte, Cornelius, Linder, and Brewer, the researchers used sports teams as the subject of their study. The authors suggest that hazing can result in some positive outcomes. During the hazing process, a bond between the two parties (the hazer and the hazee) grew. Many people view hazing as an effective way to teach respect and develop discipline and loyalty within the group, and believe that hazing is a necessary component of initiation rites. Hazing can be used as a way to engender conformity within a social group, something that can be seen in many sociological studies. Moreover, initiation rituals when managed effectively can serve to build team cohesion and improve team performance, while negative and detrimental forms of hazing alienate and disparage individuals.

Dissonance can produce feelings of group attraction or social identity among initiates after the hazing experience because they want to justify the effort used. Rewards during initiations or hazing rituals matter in that initiates who feel more rewarded express stronger group identity. As well as increasing group attraction, hazing can produce conformity among new members. Hazing could also increase feelings of affiliation because of the stressful nature of the hazing experience. Also, hazing has a hard time of being extinguished by those who saw it to be potentially dangerous like administration in education or law enforcement. In an article published by Linda Wilson, she and the National Pan-Hellenic Council Leaders at North Carolina Agricultural and Technical State University gave their perspectives and opinions on hazing at their institution, and she discussed why hazing is so hard to discontinue. The reason why is because the act of hazing is deeply rooted traditionally, so it becomes hard to break those traditional actions. For example, York College in Pennsylvania tried to solve this issue with suspending students who partake in the act. However, it is hard to dismantle not only because of tradition, but also because it is meant to be done in private spaces. It is not meant to be public which makes getting rid of it even harder.

A 2014 paper by Harvey Whitehouse discusses theories that hazing can cause social cohesion though group identification and identity fusion. A 2017 study published in Scientific Reports found that groups that share painful or strong negative experiences can cause visceral bonding, and pro-group behavior. Students of Brazilian Jiu Jitsu who had experienced painful belt-whipping gauntlets had a higher willingness to donate time or risk their lives for the club.

Scope

Tied and blindfolded first-year students from Universidad de Talca, Chile

United States

According to one of the largest US National Surveys regarding hazing including over 60,000 student athletes from 2,400 colleges and universities:

Over 325,000 athletes at more than 1,000 National Collegiate Athletic Association schools in the US participated in intercollegiate sports during 1998–99. Of these athletes:

  • More than a quarter of a million experienced some form of hazing to join a college athletic team.
  • One in five was subjected to unacceptable and potentially illegal hazing. They were kidnapped, beaten or tied up and abandoned. They were also forced to commit crimes – destroying property, making prank phone calls or harassing others.
  • Half were required to participate in drinking contests or alcohol-related hazing.
  • Two in five consumed alcohol on recruitment visits even before enrolling.
  • Two-thirds were subjected to humiliating hazing, such as being yelled or sworn at, forced to wear embarrassing clothing (if any clothing at all) or forced to deprive themselves of sleep, food or personal hygiene.
  • One in five participated exclusively in positive initiations, such as team trips or ropes courses.

The survey found that 79% of college athletes experienced some form of hazing to join their team, yet 60% of the student-athletes respondents indicated that they would not report incidents of hazing.

A 2007 survey at American colleges found 55% of students in "clubs, teams, and organizations" experienced behavior the survey defined as hazing, including in varsity athletics and Greek-letter organizations. This survey found 47% of respondents experienced hazing before college, and in 25% of hazing cases, school staff were aware of the activity. 90% of students who experienced behavior the researchers defined as hazing did not consider themselves to have been hazed, and 95% of those who experienced what they themselves defined as hazing did not report it. The most common hazing-related activities reported in student groups included alcohol consumption, humiliation, isolation, sleep deprivation, and sex acts.

Police forces, especially those with a paramilitary tradition, or sub-units of police forces such as tactical teams, may also have hazing rituals. Rescue services, such as lifeguards or air-sea rescue teams may have hazing rituals.

Belgium

Hazing rituals are a common practice in student clubs (fraternities and sororities, called studentenclubs) and student societies (called studentenverenigingen, studentenkringen or faculteitskringen). The latter is attached to the faculty of the university, while the first ones are privately operated. Hazing rituals in student societies have generally been safer than those in student clubs, precisely because they are to some extent regulated by universities.

For example, KU Leuven drew up a hazing charter in 2013 following an animal cruelty incident in the hazing ritual of student club Reuzegom. The charter was to be signed by student societies, fraternities and sororities. Signing the charter would have been a pledge to notify the city of the place and time of the hazing ceremony, and to abstain from violence, racism, extortion, bullying, sexual assault, discrimination, and the use of vertebrate animals. Reuzegom, as well as the other fraternities and sororities of the Antwerp Guild, refused. In 2018, twenty-year-old student Sanda Dia died from multiple organ failure in the Reuzegom hazing ritual as a result of racially motivated abuse by fellow Reuzegom members. As of 2019, a few sororities have signed the charter, as well as all student societies. In April 2019, the 28 remaining fraternities in Leuven signed the charter.

Netherlands

In the Netherlands, the so-called 'traditional fraternities' have an introduction time which includes hazing rituals. The pledges go for a few days to a camp during which they undergo hazing rituals but are meanwhile introduced in the traditions of the fraternity. After camp, there are usually evenings or whole days in which the pledges have to be present at the fraternity, although slowly the pressure is released and the relations become somewhat more equal. Often, pledges collect or perform chores to raise funds for charity. At the end of the hazing period, the inauguration of the new members take place.

Incidents have occurred resulting in injuries and death. Often these incidents occur when members wish to join a house, (prestigious) sub-structure or commission for which they undergo a second (and usually heavier) hazing ritual. Incidents mostly occur during hazing rituals for these sub-structures, since there is less or no control from the fraternity board. Also, these sub-structure hazing rituals involve often excessive alcohol abuse, even when alcohol has become a taboo in hazing of the fraternity itself. Other situations causing additional risks for incidents are members (often joining the hazing camp but not designated with any responsibility) separating pledges and taking them away from the main group to 'amuse themselves' with them.

In 1965 a student at Utrecht University choked to death during a hazing ritual (Roetkapaffaire). There was public outrage when the perpetrators were convicted to light conditional sentences while left-wing Provo demonstrators were given unconditional prison sentences for order disturbances. The fact that the magistrates handling the case were all alumni of the same fraternity gave rise to accusions of nepotism and class justice. Two incidents in 1997, leading to one heavy injury and one death, lead to sharpened scrutiny over hazing. Hazing incidents have nevertheless occurred since, but justice is becoming keener in persecuting perpetrators.

The Netherlands has no anti-hazing legislation. Hazing incidents can be handled by internal resolution by the fraternity itself (the lightest cases), and via the criminal justice system as assault or in case of death negligent homicide or manslaughter. Universities as a rule support student unions (financially and by granting board members of such union a discount on the required number of ECTS credits) but can in the most extreme case suspend or withdraw recognition and support for such union.

Philippines

According to R. Dayao, hazing, usually in initiation rites of fraternities, has a long history in the Philippines, and has been a source of public controversy after many cases that resulted to death of the neophyte. The first recorded death due to hazing in the Philippines was recorded in 1954, with the death of Gonzalo Mariano Albert. Hazing was regulated under the Anti-Hazing Act of 1995, after the death of Leonardo Villa in 1991, but many cases, usually causing severe injury or death, continued even after it was enacted, the latest involving Darwin Dormitorio, a 20-year old Cadet 4th Class from the Philippine Military Academy.

Republic of Ireland

Hazing incidents are rare in the Republic of Ireland, but are known at certain elite educational institutions.

At Trinity College Dublin, an all-male society, Knights of the Campanile, was implicated in a hazing incident in 2019, where initiates were required to eat large amounts of butter. Campus newspaper The University Times was criticised for using secret recording devices to record the event. Dublin University Boat Club are also known for hazing, with rituals including consumption of alcohol, stripping to ones underwear, caning with bamboo rods, push-ups, being shouted at, standing in the rain, being tied together by shoelaces and crawling a maze while being hit with pillows. Hazing is common at Trinity sports societies and teams. Zeta Psi fraternity has a presence at Trinity as well, and some hazing has been reported.

Hazing also took place at Dublin City University's Accounting & Finance Society in 2018, where first-years standing for committee positions had to complete a variety of sexualised games. The club was suspended for a year as a result.

A report on Gaelic games county players noted that 6% of players reported were aware of forced binge drinking as a form of hazing.

Ragging in South Asia

Ragging is a practice similar to hazing in educational institutions in the Indo subcontinent. The word is mainly used in India, Pakistan, Bangladesh and Sri Lanka. Ragging involves existing students baiting or bullying new students. It often takes a malignant form wherein the newcomers may be subjected to psychological or physical torture. In 2009 the University Grants Commission of India imposed regulations upon Indian universities to help curb ragging, and launched a toll-free 'anti ragging helpline'. The effectiveness of these measures are unknown; many accused of ragging freshmen are either let out with a warning or saved from legal action by political or caste lobbyists.

Although ragging is a criminal offense in Sri Lanka under the Prohibition of Ragging and other Forms of Violence in Educational institutions Act, No. 20 of 1998 and carries a severe punishment, several variations of ragging can be observed in universities around the country. Through the years this practice has worsened to all types of violence including sexual violence, harassment and has also claimed the lives of several students. The university grants commission of Sri Lanka, have set up several pathways to report ragging incidents, including a special office, helpline and a mobile app where students can make a complaint anonymously or seek help.

Controversy

The "Scenes of Hazing", as portrayed in an early student yearbook of the Massachusetts Agricultural College. Circa 1879.

The practice of ritual abuse among social groups is not clearly understood. This is partly due to the secretive nature of the activities, especially within collegiate fraternities and sororities, and in part a result of long-term acceptance of hazing. Thus, it has been difficult for researchers to agree on the underlying social and psychological mechanisms that perpetuate hazing. In military circles hazing is sometimes assumed to test recruits under situations of stress and hostility. Although in no way a recreation of combat, hazing does put people into stressful situations that they are unable to control, which allegedly should weed out the weaker members before being put in situations where failure to perform will cost lives. A portion of the military training course known as Survival, Evasion, Resistance and Escape (SERE) simulates as closely as is feasible the physical and psychological conditions of a POW camp.

The problem with this approach, according to opponents, is that the stress and hostility comes from inside the group, and not from outside as in actual combat situation, creating suspicion and distrust towards the superiors and comrades-in-arms. Willing participants may be motivated by a desire to prove to senior soldiers their stability in future combat situations, making the unit more secure, but blatantly brutal hazing can in fact produce negative results, making the units more prone to break, desert or mutiny than those without hazing traditions, as observed in the Russian army in Chechnya, where units with the strongest traditions of dedovschina were the first to break and desert under enemy fire. At worst, hazing may lead into fragging incidents. Colleges and universities sometimes avoid publicizing hazing incidents for fear of damaging institutional reputations or incurring financial liability to victims.

In a 1999 study, a survey of 3,293 collegiate athletes, coaches, athletic directors and deans found a variety of approaches to prevent hazing, including strong disciplinary and corrective measures for known cases, implementation of athletic, behavioral, and academic standards guiding recruitment; provisions for alternative bonding and recognition events for teams to prevent hazing; and law enforcement involvement in monitoring, investigating, and prosecuting hazing incidents. Hoover's research suggested half of all college athletes are involved in alcohol-related hazing incidents, while one in five are involved in potentially illegal hazing incidents. Only another one in five was involved in what Hoover described as positive initiation events, such as taking team trips or running obstacle courses.

Hoover wrote: "Athletes most at risk for any kind of hazing for college sports were men; non-Greek members; and either swimmers, divers, soccer players, or lacrosse players. The campuses where hazing was most likely to occur were primarily in eastern or southern states with no anti-hazing laws. The campuses were rural, residential, and had Greek systems." (Hoover uses the term "Greek" to refer to U.S.-style fraternities and sororities.) Hoover found that non-fraternity members were most at risk of hazing, and that football players are most at risk of potentially dangerous or illegal hazing. In the May issue of the American Journal of Emergency Medicine, Michelle Finkel reported that hazing injuries are often not recognized for their true cause in emergency medical centers. The doctor said hazing victims sometimes hide the real cause of injuries out of shame or to protect those who caused the harm. In protecting their abusers, hazing victims can be compared with victims of domestic violence, Finkel wrote.

Finkel cites hazing incidents including "beating or kicking to the point of traumatic injury or death, burning or branding, excessive calisthenics, being forced to eat unpleasant substances, and psychological or sexual abuse of both males and females". Reported coerced sexual activity is sometimes considered "horseplay" rather than rape, she wrote. Finkel quoted from Hank Nuwer's book "Wrongs of Passage" which counted 56 hazing deaths between 1970 and 1999.

In November 2005, controversy arose over a video showing Royal Marines fighting naked and intoxicated as part of a hazing ritual. The fight culminated with one soldier receiving a kick to the face, rendering him unconscious. The victim, according to the BBC, said "It's just Marine humour". The Marine who leaked the video said "The guy laid out was inches from being dead." Under further investigation, the Marines had just returned from a six-month tour of Iraq, and were in their "cooling down" period, in which they spend two weeks at a naval base before they are allowed back into society. The man who suffered the kick to the head did not press charges.

In 2008, a national hazing study was conducted by Dr Elizabeth Allan and Dr Mary Madden from the University of Maine. This investigation is the most comprehensive study of hazing to date and includes survey responses from more than 11,000 undergraduate students at 53 colleges and universities in different regions of the U.S. and interviews with more than 300 students and staff at 18 of these campuses. Through the vision and efforts of many, this study fills a major gap in the research and extends the breadth and depth of knowledge and understanding about hazing. Ten initial findings are described in the report, Hazing in View: College Students at Risk. These include:

  1. More than half of college students involved in clubs, teams, and organizations experience hazing.
  2. Nearly half (47%) of students have experienced hazing before coming to college.
  3. Alcohol consumption, humiliation, isolation, sleep deprivation, and sex acts are hazing practices common across student groups.

Disability-adjusted life year

From Wikipedia, the free encyclopedia
 
Disability-adjusted life years out of 100,000 lost due to any cause in 2004.
  no data
  fewer than 9,250
  9,250–16,000
  16,000–22,750
  22,750–29,500
  29,500–36,250
  36,250–43,000
  43,000–49,750
  49,750–56,500
  56,500–63,250
  63,250–70,000
  70,000–80,000
  more than 80,000

The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. It was developed in the 1990s as a way of comparing the overall health and life expectancy of different countries.

The DALY has become more common in the field of public health and health impact assessment (HIA). It not only includes the potential years of life lost due to premature death, but also includes equivalent years of 'healthy' life lost by virtue of being in states of poor health or disability. In so doing, mortality and morbidity are combined into a single, common metric.

Calculation

adjusted life year

The disability-adjusted life year is a societal measure of the disease or disability burden in populations. DALYs are calculated by combining measures of life expectancy as well as the adjusted quality of life during a burdensome disease or disability for a population. DALYs are related to the quality-adjusted life year (QALY) measure; however, QALYs only measure the benefit with and without medical intervention and therefore do not measure the total burden. Also, QALYs tend to be an individual measure, and not a societal measure.

Traditionally, health liabilities were expressed using one measure, the years of life lost (YLL) due to dying early. A medical condition that did not result in dying younger than expected was not counted. The burden of living with a disease or disability is measured by the years lost due to disability (YLD) component, sometimes also known as years lost due to disease or years lived with disability/disease.

DALYs are calculated by taking the sum of these two components:

DALY = YLL + YLD

The DALY relies on an acceptance that the most appropriate measure of the effects of chronic illness is time, both time lost due to premature death and time spent disabled by disease. One DALY, therefore, is equal to one year of healthy life lost.

How much a medical condition affects a person is called the disability weight (DW). This is determined by disease or disability and does not vary with age. Tables have been created of thousands of diseases and disabilities, ranging from Alzheimer's disease to loss of finger, with the disability weight meant to indicate the level of disability that results from the specific condition.

Examples of disability weight
Condition DW 2004 DW 2010
Alzheimer's and other dementias 0.666 0.666
Blindness 0.594 0.195
Schizophrenia 0.528 0.576
AIDS, not on ART 0.505 0.547
Burns 20%–60% of body 0.441 0.438
Fractured femur 0.372 0.308
Moderate depression episode 0.350 0.406
Amputation of foot 0.300 0.021–0.1674
Deafness 0.229 0.167–0.281
Infertility 0.180 0.026–0.056
Amputation of finger 0.102 0.030
Lower back pain 0.061 0.0322–0.0374

Examples of the disability weight are shown on the right. Some of these are "short term", and the long-term weights may be different.

The most noticeable change between the 2004 and 2010 figures for disability weights above are for blindness as it was considered the weights are a measure of health rather than well-being (or welfare) and a blind person is not considered to be ill. "In the GBD terminology, the term disability is used broadly to refer to departures from optimal health in any of the important domains of health."

At the population level, the disease burden as measured by DALYs is calculated by adding YLL to YLD. YLL uses the life expectancy at the time of death. YLD is determined by the number of years disabled weighted by level of disability caused by a disability or disease using the formula:

YLD = I × DW × L

In this formula, I = number of incident cases in the population, DW = disability weight of specific condition, and L = average duration of the case until remission or death (years). There is also a prevalence (as opposed to incidence) based calculation for YLD. Number of years lost due to premature death is calculated by

YLL = N × L

where N = number of deaths due to condition, L = standard life expectancy at age of death. Note that life expectancies are not the same at different ages. For example, in Paleolithic era, life expectancy at birth was 33 years, but life expectancy at the age of 15 was an additional 39 years (total 54).

Historically Japanese life expectancy statistics have been used as the standard for measuring premature death, as the Japanese have the longest life expectancies. Other approaches have since emerged, include using national life tables for YLL calculations, or using the reference life table derived by the GBD study.

Age weighting

Some studies use DALYs calculated to place greater value on a year lived as a young adult. This formula produces average values around age 10 and age 55, a peak around age 25, and lowest values among very young children and very old people.

The World Health Organization (WHO) used age weighting and time discounting at 3 percent in DALYs prior to 2010 but discontinued using them starting in 2010.

There are two components to this differential accounting of time: age-weighting and time-discounting. Age-weighting is based on the theory of human capital. Commonly, years lived as a young adult are valued more highly than years spent as a young child or older adult, as these are years of peak productivity. Age-weighting receives considerable criticism for valuing young adults at the expense of children and the old. Some criticize, while others rationalize, this as reflecting society's interest in productivity and receiving a return on its investment in raising children. This age-weighting system means that somebody disabled at 30 years of age, for ten years, would be measured as having a higher loss of DALYs (a greater burden of disease), than somebody disabled by the same disease or injury at the age of 70 for ten years.

This age-weighting function is by no means a universal methodology in HALY studies, but is common when using DALYs. Cost-effectiveness studies using QALYs, for example, do not discount time at different ages differently. This age-weighting function applies only to the calculation of DALYs lost due to disability. Years lost to premature death are determined from the age at death and life expectancy.

The Global Burden of Disease Study (GBD) 2001–2002 counted disability adjusted life years equally for all ages, but the GBD 1990 and GBD 2004 studies used the formula

where is the age at which the year is lived and is the value assigned to it relative to an average value of 1.

In these studies, future years were also discounted at a 3% rate to account for future health care losses. Time discounting, which is separate from the age-weighting function, describes preferences in time as used in economic models.

The effects of the interplay between life expectancy and years lost, discounting, and social weighting are complex, depending on the severity and duration of illness. For example, the parameters used in the GBD 1990 study generally give greater weight to deaths at any year prior to age 39 than afterward, with the death of a newborn weighted at 33 DALYs and the death of someone aged 5–20 weighted at approximately 36 DALYs.

As a result of numerous discussions, by 2010 the World Health Organization had abandoned the ideas of age weighting and time discounting. They had also substituted the idea of prevalence for incidence (when a condition started) because this is what surveys measure.

Economic applications

The methodology is not an economic measure. It measures how much healthy life is lost. It does not assign a monetary value to any person or condition, and it does not measure how much productive work or money is lost as a result of death and disease. However, HALYs, including DALYs and QALYs, are especially useful in guiding the allocation of health resources as they provide a common numerator, allowing for the expression of utility in terms of dollar/DALY, or dollar/QALY. For example, in Gambia, provision of the pneumococcal conjugate vaccine costs $670 per DALY saved. This number can then be compared to other treatments for other diseases, to determine whether investing resources in preventing or treating a different disease would be more efficient in terms of overall health.

Examples

Schizophrenia has a 0.53 weighting and a broken femur a 0.37 weighting in the latest WHO weightings.

Australia

Cancer (25.1/1,000), cardiovascular (23.8/1,000), mental problems (17.6/1,000), neurological (15.7/1,000), chronic respiratory (9.4/1,000) and diabetes (7.2/1,000) are the main causes of good years of expected life lost to disease or premature death. Despite this, Australia has one of the longest life expectancies in the world.

Africa

These illustrate the problematic diseases and outbreaks occurring in 2013 in Zimbabwe, shown to have the greatest impact on health disability were typhoid, anthrax, malaria, common diarrhea, and dysentery.

PTSD rates

Posttraumatic stress disorder (PTSD) DALY estimates from 2004 for the world's 25 most populous countries give Asian/Pacific countries and the United States as the places where PTSD impact is most concentrated (as shown here).

Noise-induced hearing loss

The disability-adjusted life years attributable to hearing impairment for noise-exposed U.S. workers across all industries was calculated to be 2.53 healthy years lost annually per 1,000 noise-exposed workers. Workers in the mining and construction sectors lost 3.45 and 3.09 healthy years per 1,000 workers, respectively. Overall, 66% of the sample worked in the manufacturing sector and represented 70% of healthy years lost by all workers.

History and usage

Originally developed by Harvard University for the World Bank in 1990, the World Health Organization subsequently adopted the method in 1996 as part of the Ad hoc Committee on Health Research "Investing in Health Research & Development" report. The DALY was first conceptualized by Christopher J. L. Murray and Lopez in work carried out with the World Health Organization and the World Bank known as the Global Burden of Disease Study, which was published in 1990. It is now a key measure employed by the United Nations World Health Organization in such publications as its Global Burden of Disease.

The DALY was also used in the 1993 World Development Report.

Criticism

Both DALYs and QALYs are forms of HALYs, health-adjusted life years.

Some critics have alleged that DALYs are essentially an economic measure of human productive capacity for the affected individual. In response, defenders of DALYs have argued that while DALYs have an age-weighting function that has been rationalized based on the economic productivity of persons at that age, health-related quality of life measures are used to determine the disability weights, which range from 0 to 1 (no disability to 100% disabled) for all disease. These defenders emphasize that disability weights are based not on a person's ability to work, but rather on the effects of the disability on the person's life in general. Hence, mental illness is one of the leading diseases as measured by global burden of disease studies, with depression accounting for 51.84 million DALYs. Perinatal conditions, which affect infants with a very low age-weight function, are the leading cause of lost DALYs at 90.48 million. Measles is fifteenth at 23.11 million.

Some commentators have expressed doubt over whether the disease burden surveys (such as EQ-5D) fully capture the impacts of mental illness, due to factors including ceiling effects.

According to Pliskin et al., the QALY model requires utility independent, risk neutral, and constant proportional tradeoff behaviour. Because of these theoretical assumptions, the meaning and usefulness of the QALY is debated. Perfect health is difficult, if not impossible, to define. Some argue that there are health states worse than being dead, and that therefore there should be negative values possible on the health spectrum (indeed, some health economists have incorporated negative values into calculations). Determining the level of health depends on measures that some argue place disproportionate importance on physical pain or disability over mental health.

The method of ranking interventions on grounds of their cost per QALY gained ratio (or ICER) is controversial because it implies a quasi-utilitarian calculus to determine who will or will not receive treatment. However, its supporters argue that since health care resources are inevitably limited, this method enables them to be allocated in the way that is approximately optimal for society, including most patients. Another concern is that it does not take into account equity issues such as the overall distribution of health states – particularly since younger, healthier cohorts have many times more QALYs than older or sicker individuals. As a result, QALY analysis may undervalue treatments which benefit the elderly or others with a lower life expectancy. Also, many would argue that all else being equal, patients with more severe illness should be prioritised over patients with less severe illness if both would get the same absolute increase in utility.

As early as 1989, Loomes and McKenzie recommended that research be conducted concerning the validity of QALYs. In 2010, with funding from the European Commission, the European Consortium in Healthcare Outcomes and Cost-Benefit Research (ECHOUTCOME) began a major study on QALYs as used in health technology assessment. Ariel Beresniak, the study's lead author, was quoted as saying that it was the "largest-ever study specifically dedicated to testing the assumptions of the QALY". In January 2013, at its final conference, ECHOUTCOME released preliminary results of its study which surveyed 1361 people "from academia" in Belgium, France, Italy and the UK. The researchers asked the subjects to respond to 14 questions concerning their preferences for various health states and durations of those states (e.g., 15 years limping versus 5 years in a wheelchair). They concluded that "preferences expressed by the respondents were not consistent with the QALY theoretical assumptions" that quality of life can be measured in consistent intervals, that life-years and quality of life are independent of each other, that people are neutral about risk, and that willingness to gain or lose life-years is constant over time. ECHOUTCOME also released "European Guidelines for Cost-Effectiveness Assessments of Health Technologies", which recommended not using QALYs in healthcare decision making. Instead, the guidelines recommended that cost-effectiveness analyses focus on "costs per relevant clinical outcome".

In response to the ECHOUTCOME study, representatives of the National Institute for Health and Care Excellence, the Scottish Medicines Consortium, and the Organisation for Economic Co-operation and Development made the following points. First, QALYs are better than alternative measures. Second, the study was "limited". Third, problems with QALYs were already widely acknowledged. Fourth, the researchers did not take budgetary constraints into consideration. Fifth, the UK's National Institute for Health and Care Excellence uses QALYs that are based on 3395 interviews with residents of the UK, as opposed to residents of several European countries. Finally, people who call for the elimination of QALYs may have "vested interests".

Clash of Civilizations

From Wikipedia, the free encyclopedia
 
The Clash of Civilizations and the Remaking of World Order
Clash civilizations.jpg
AuthorSamuel P. Huntington
CountryUnited States
LanguageEnglish
PublisherSimon & Schuster
Publication date
1996
ISBN978-0-684-84441-1

The Clash of Civilizations is a thesis that people's cultural and religious identities will be the primary source of conflict in the post–Cold War world. The American political scientist Samuel P. Huntington argued that future wars would be fought not between countries, but between cultures. It was proposed in a 1992 lecture at the American Enterprise Institute, which was then developed in a 1993 Foreign Affairs article titled "The Clash of Civilizations?", in response to his former student Francis Fukuyama's 1992 book, The End of History and the Last Man. Huntington later expanded his thesis in a 1996 book The Clash of Civilizations and the Remaking of World Order.

The phrase itself was earlier used by Albert Camus in 1946, by Girilal Jain in his analysis of the Ayodhya dispute in 1988, by Bernard Lewis in an article in the September 1990 issue of The Atlantic Monthly titled "The Roots of Muslim Rage" and by Mahdi El Mandjra in his book "La première guerre civilisationnelle" published in 1992. Even earlier, the phrase appears in a 1926 book regarding the Middle East by Basil Mathews: Young Islam on Trek: A Study in the Clash of Civilizations (p. 196). This expression derives from "clash of cultures", already used during the colonial period and the Belle Époque.

Huntington began his thinking by surveying the diverse theories about the nature of global politics in the post–Cold War period. Some theorists and writers argued that human rights, liberal democracy, and the capitalist free market economy had become the only remaining ideological alternative for nations in the post–Cold War world. Specifically, Francis Fukuyama argued that the world had reached the 'end of history' in a Hegelian sense.

Huntington believed that while the age of ideology had ended, the world had only reverted to a normal state of affairs characterized by cultural conflict. In his thesis, he argued that the primary axis of conflict in the future will be along cultural lines. As an extension, he posits that the concept of different civilizations, as the highest category of cultural identity, will become increasingly useful in analyzing the potential for conflict. At the end of his 1993 Foreign Affairs article, "The Clash of Civilizations?", Huntington writes, "This is not to advocate the desirability of conflicts between civilizations. It is to set forth descriptive hypothesis as to what the future may be like."

In addition, the clash of civilizations, for Huntington, represents a development of history. In the past, world history was mainly about the struggles between monarchs, nations and ideologies, such as that seen within Western civilization. However, after the end of the Cold War, world politics moved into a new phase, in which non-Western civilizations are no longer the exploited recipients of Western civilization but have become additional important actors joining the West to shape and move world history.

Major civilizations according to Huntington

The clash of civilizations according to Huntington (1996) The Clash of Civilizations and the Remaking of World Order

Huntington divided the world into the "major civilizations" in his thesis as such:

Huntington's thesis of civilizational clash

Huntington at the 2004 World Economic Forum

Huntington argues that the trends of global conflict after the end of the Cold War are increasingly appearing at these civilizational divisions. Wars such as those following the break up of Yugoslavia, in Chechnya, and between India and Pakistan were cited as evidence of inter-civilizational conflict. He also argues that the widespread Western belief in the universality of the West's values and political systems is naïve and that continued insistence on democratization and such "universal" norms will only further antagonize other civilizations. Huntington sees the West as reluctant to accept this because it built the international system, wrote its laws, and gave it substance in the form of the United Nations.

Huntington identifies a major shift of economic, military, and political power from the West to the other civilizations of the world, most significantly to what he identifies as the two "challenger civilizations", Sinic and Islam.

In Huntington's view, East Asian Sinic civilization is culturally asserting itself and its values relative to the West due to its rapid economic growth. Specifically, he believes that China's goals are to reassert itself as the regional hegemon, and that other countries in the region will 'bandwagon' with China due to the history of hierarchical command structures implicit in the Confucian Sinic civilization, as opposed to the individualism and pluralism valued in the West. Regional powers such as the two Koreas and Vietnam will acquiesce to Chinese demands and become more supportive of China rather than attempting to oppose it. Huntington therefore believes that the rise of China poses one of the most significant problems and the most powerful long-term threat to the West, as Chinese cultural assertion clashes with the American desire for the lack of a regional hegemony in East Asia.

Huntington argues that the Islamic civilization has experienced a massive population explosion which is fueling instability both on the borders of Islam and in its interior, where fundamentalist movements are becoming increasingly popular. Manifestations of what he terms the "Islamic Resurgence" include the 1979 Iranian revolution and the first Gulf War. Perhaps the most controversial statement Huntington made in the Foreign Affairs article was that "Islam has bloody borders". Huntington believes this to be a real consequence of several factors, including the previously mentioned Muslim youth bulge and population growth and Islamic proximity to many civilizations including Sinic, Orthodox, Western, and African.

Huntington sees Islamic civilization as a potential ally to China, both having more revisionist goals and sharing common conflicts with other civilizations, especially the West. Specifically, he identifies common Chinese and Islamic interests in the areas of weapons proliferation, human rights, and democracy that conflict with those of the West, and feels that these are areas in which the two civilizations will cooperate.

Russia, Japan, and India are what Huntington terms 'swing civilizations' and may favor either side. Russia, for example, clashes with the many Muslim ethnic groups on its southern border (such as Chechnya) but—according to Huntington—cooperates with Iran to avoid further Muslim-Orthodox violence in Southern Russia, and to help continue the flow of oil. Huntington argues that a "Sino-Islamic connection" is emerging in which China will cooperate more closely with Iran, Pakistan, and other states to augment its international position.

Huntington also argues that civilizational conflicts are "particularly prevalent between Muslims and non-Muslims", identifying the "bloody borders" between Islamic and non-Islamic civilizations. This conflict dates back as far as the initial thrust of Islam into Europe, its eventual expulsion in the Iberian reconquest, the attacks of the Ottoman Turks on Eastern Europe and Vienna, and the European imperial division of the Islamic nations in the 1800s and 1900s.

Huntington also believes that some of the factors contributing to this conflict are that both Christianity (upon which Western civilization is based) and Islam are:

  • Missionary religions, seeking conversion of others
  • Universal, "all-or-nothing" religions, in the sense that it is believed by both sides that only their faith is the correct one
  • Teleological religions, that is, that their values and beliefs represent the goals of existence and purpose in human existence.

More recent factors contributing to a Western–Islamic clash, Huntington wrote, are the Islamic Resurgence and demographic explosion in Islam, coupled with the values of Western universalism—that is, the view that all civilizations should adopt Western values—that infuriate Islamic fundamentalists. All these historical and modern factors combined, Huntington wrote briefly in his Foreign Affairs article and in much more detail in his 1996 book, would lead to a bloody clash between the Islamic and Western civilizations.

Why civilizations will clash

Huntington offers six explanations for why civilizations will clash:

  1. Differences among civilizations are too basic in that civilizations are differentiated from each other by history, language, culture, tradition, and, most importantly, religion. These fundamental differences are the product of centuries and the foundations of different civilizations, meaning they will not be gone soon.
  2. The world is becoming a smaller place. As a result, interactions across the world are increasing, which intensify "civilization consciousness" and the awareness of differences between civilizations and commonalities within civilizations.
  3. Due to economic modernization and social change, people are separated from longstanding local identities. Instead, religion has replaced this gap, which provides a basis for identity and commitment that transcends national boundaries and unites civilizations.
  4. The growth of civilization-consciousness is enhanced by the dual role of the West. On the one hand, the West is at a peak of power. At the same time, a return-to-the-roots phenomenon is occurring among non-Western civilizations. A West at the peak of its power confronts non-Western countries that increasingly have the desire, the will and the resources to shape the world in non-Western ways.
  5. Cultural characteristics and differences are less mutable and hence less easily compromised and resolved than political and economic ones.
  6. Economic regionalism is increasing. Successful economic regionalism will reinforce civilization-consciousness. Economic regionalism may succeed only when it is rooted in a common civilization.

The West versus the Rest

Huntington suggests that in the future the central axis of world politics tends to be the conflict between Western and non-Western civilizations, in Stuart Hall's phrase, the conflict between "the West and the Rest". He offers three forms of general and fundamental actions that non-Western civilization can take in response to Western countries.

  1. Non-Western countries can attempt to achieve isolation in order to preserve their own values and protect themselves from Western invasion. However, Huntington argues that the costs of this action are high and only a few states can pursue it.
  2. According to the theory of "band-wagoning" non-Western countries can join and accept Western values.
  3. Non-Western countries can make an effort to balance Western power through modernization. They can develop economic, military power and cooperate with other non-Western countries against the West while still preserving their own values and institutions. Huntington believes that the increasing power of non-Western civilizations in international society will make the West begin to develop a better understanding of the cultural fundamentals underlying other civilizations. Therefore, Western civilization will cease to be regarded as "universal" but different civilizations will learn to coexist and join to shape the future world.

Core state and fault line conflicts

In Huntington's view, intercivilizational conflict manifests itself in two forms: fault line conflicts and core state conflicts.

Fault line conflicts are on a local level and occur between adjacent states belonging to different civilizations or within states that are home to populations from different civilizations.

Core state conflicts are on a global level between the major states of different civilizations. Core state conflicts can arise out of fault line conflicts when core states become involved.

These conflicts may result from a number of causes, such as: relative influence or power (military or economic), discrimination against people from a different civilization, intervention to protect kinsmen in a different civilization, or different values and culture, particularly when one civilization attempts to impose its values on people of a different civilization.

Modernization, Westernization, and "torn countries"

Japan, China and the Four Asian Tigers have modernized in many respects while maintaining traditional or authoritarian societies which distinguish them from the West. Some of these countries have clashed with the West and some have not.

Perhaps the ultimate example of non-Western modernization is Russia, the core state of the Orthodox civilization. Huntington argues that Russia is primarily a non-Western state although he seems to agree that it shares a considerable amount of cultural ancestry with the modern West. According to Huntington, the West is distinguished from Orthodox Christian countries by its experience of the Renaissance, Reformation, the Enlightenment; by overseas colonialism rather than contiguous expansion and colonialism; and by the infusion of Classical culture through ancient Greece rather than through the continuous trajectory of the Byzantine Empire.

Huntington refers to countries that are seeking to affiliate with another civilization as "torn countries". Turkey, whose political leadership has systematically tried to Westernize the country since the 1920s, is his chief example. Turkey's history, culture, and traditions are derived from Islamic civilization, but Turkey's elite, beginning with Mustafa Kemal Atatürk who took power as first President in 1923, imposed Western institutions and dress, embraced the Latin alphabet, joined NATO, and has sought to join the European Union.

Mexico and Russia are also considered to be torn by Huntington. He also gives the example of Australia as a country torn between its Western civilizational heritage and its growing economic engagement with Asia.

According to Huntington, a torn country must meet three requirements to redefine its civilizational identity. Its political and economic elite must support the move. Second, the public must be willing to accept the redefinition. Third, the elites of the civilization that the torn country is trying to join must accept the country.

The book claims that to date no torn country has successfully redefined its civilizational identity, this mostly due to the elites of the 'host' civilization refusing to accept the torn country, though if Turkey gained membership in the European Union, it has been noted that many of its people would support Westernization, as in the following quote by EU Minister Egemen Bağış: "This is what Europe needs to do: they need to say that when Turkey fulfills all requirements, Turkey will become a member of the EU on date X. Then, we will regain the Turkish public opinion support in one day." If this were to happen, it would, according to Huntington, be the first to redefine its civilizational identity.

Criticism

The book has been criticized by various academic writers, who have empirically, historically, logically, or ideologically challenged its claims (Fox, 2005; Mungiu Pippidi & Mindruta, 2002; Henderson & Tucker, 2001; Russett, Oneal, & Cox, 2000; Harvey, 2000). Political scientist Paul Musgrave writes that Clash of Civilization "enjoys great cachet among the sort of policymaker who enjoys name-dropping Sun Tzu, but few specialists in international relations rely on it or even cite it approvingly. Bluntly, Clash has not proven to be a useful or accurate guide to understanding the world."

In an article explicitly referring to Huntington, scholar Amartya Sen (1999) argues that "diversity is a feature of most cultures in the world. Western civilization is no exception. The practice of democracy that has won out in the modern West is largely a result of a consensus that has emerged since the Enlightenment and the Industrial Revolution, and particularly in the last century or so. To read in this a historical commitment of the West—over the millennia—to democracy, and then to contrast it with non-Western traditions (treating each as monolithic) would be a great mistake."

In his 2003 book Terror and Liberalism, Paul Berman argues that distinct cultural boundaries do not exist in the present day. He argues there is no "Islamic civilization" nor a "Western civilization", and that the evidence for a civilization clash is not convincing, especially when considering relationships such as that between the United States and Saudi Arabia. In addition, he cites the fact that many Islamic extremists spent a significant amount of time living or studying in the Western world. According to Berman, conflict arises because of philosophical beliefs various groups share (or do not share), regardless of cultural or religious identity.

Timothy Garton Ash objects to the 'extreme cultural determinism... crude to the point of parody' of Huntington's idea that Catholic and Protestant Europe is headed for democracy, but that Orthodox Christian and Islamic Europe must accept dictatorship.

Edward Said issued a response to Huntington's thesis in his 2001 article, "The Clash of Ignorance". Said argues that Huntington's categorization of the world's fixed "civilizations" omits the dynamic interdependency and interaction of culture. A longtime critic of the Huntingtonian paradigm, and an outspoken proponent of Arab issues, Said (2004) also argues that the clash of civilizations thesis is an example of "the purest invidious racism, a sort of parody of Hitlerian science directed today against Arabs and Muslims" (p. 293).

Noam Chomsky has criticized the concept of the clash of civilizations as just being a new justification for the United States "for any atrocities that they wanted to carry out", which was required after the Cold War as the Soviet Union was no longer a viable threat.

In 21 Lessons for the 21st Century, Yuval Noah Harari called the clash of civilizations a misleading thesis. He wrote that Islamic fundamentalism is more of a threat to a global civilization, rather than a confrontation with the West. He also argued that talking about civilizations using analogies from evolutionary biology is wrong.

Intermediate Region

Huntington's geopolitical model, especially the structures for North Africa and Eurasia, is largely derived from the "Intermediate Region" geopolitical model first formulated by Dimitri Kitsikis and published in 1978. The Intermediate Region, which spans the Adriatic Sea and the Indus River, is neither Western nor Eastern (at least, with respect to the Far East) but is considered distinct. Concerning this region, Huntington departs from Kitsikis contending that a civilizational fault line exists between the two dominant yet differing religions (Eastern Orthodoxy and Sunni Islam), hence a dynamic of external conflict. However, Kitsikis establishes an integrated civilization comprising these two peoples along with those belonging to the less dominant religions of Shia Islam, Alevism, and Judaism. They have a set of mutual cultural, social, economic and political views and norms which radically differ from those in the West and the Far East. In the Intermediate Region, therefore, one cannot speak of a civilizational clash or external conflict, but rather an internal conflict, not for cultural domination, but for political succession. This has been successfully demonstrated by documenting the rise of Christianity from the Hellenized Roman Empire, the rise of the Islamic caliphates from the Christianized Roman Empire and the rise of Ottoman rule from the Islamic caliphates and the Christianized Roman Empire.

Mohammad Khatami, reformist president of Iran (in office 1997–2005), introduced the theory of Dialogue Among Civilizations as a response to Huntington's theory.

Opposing concepts

In recent years, the theory of Dialogue Among Civilizations, a response to Huntington's Clash of Civilizations, has become the center of some international attention. The concept was originally coined by Austrian philosopher Hans Köchler in an essay on cultural identity (1972). In a letter to UNESCO, Köchler had earlier proposed that the cultural organization of the United Nations should take up the issue of a "dialogue between different civilizations" (dialogue entre les différentes civilisations). In 2001, Iranian president Mohammad Khatami introduced the concept at the global level. At his initiative, the United Nations proclaimed the year 2001 as the "United Nations Year of Dialogue among Civilizations".

The Alliance of Civilizations (AOC) initiative was proposed at the 59th General Assembly of the United Nations in 2005 by the Spanish Prime Minister, José Luis Rodríguez Zapatero and co-sponsored by the Turkish Prime Minister Recep Tayyip Erdoğan. The initiative is intended to galvanize collective action across diverse societies to combat extremism, to overcome cultural and social barriers between mainly the Western and predominantly Muslim worlds, and to reduce the tensions and polarization between societies which differ in religious and cultural values.

Other civilizational models

Individuals

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